Bonnie Desautelle
Individual provider Active NPI Occupational Therapist · Dousman, WI
NPI 1225282957 · NPPES record last updated Nov 7, 2008
Key facts
- NPI
- 1225282957
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- 1266-026 (WI)
- Practice address
- W330S3331 Bryn Mawr Rd
Dousman, WI 53118-9719 - Phone
- (262) 392-2034
- NPI assigned
- Nov 7, 2008
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1266-026 | WI | MD | Occupational Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 1266-026 | WI | Yes |
Addresses
Primary practice location
W330S3331 Bryn Mawr Rd
Dousman, WI 53118-9719
Mailing address
W330S3331 Bryn Mawr Rd
Dousman, WI 53118-9719
Other providers in Dousman, WI
- Aurora Medical Group, Inc.
- Mary Bachman
- Rebecca Barnes
- Deanna Gail Brown
- William M Buzogany
- Sarah Margaret Ditorrice
- Steven A Donley
- Dousman Family Dentistry
- Matthew A Duma
- Kathryn Marie Eddingsaas
All providers in Dousman, WI · Occupational Therapist in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 7, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.